Medicare
Oct 28, 2024
Paduda (Unintentionally) Blasts CA Workers' Comp
A recent edition of Joe Paduda’s Managed Care Matters newsletter absolutely nails the systemic issues that plague California workers’ comp. The only twist? Mr. Paduda wasn’t ...
Oct 10, 2024
Medicare Advantage & Workers' Comp: Why Providers Reject Both
Becker’sreports that hospitals and health systems across the nation are giving up on Medicare Advantage, terminating contracts and refusing to treat patients co...
Nov 17, 2023
Paradigm Network: Medicare Cuts Impact Workers' Comp Reimbursements
At first glance, recently announced Medicare payment reductions may seem to have little to do with workers’ comp. But thanks to discount reimbursement contracts, Medicare cut...
Nov 16, 2023
Data: Medicare and CA Physician Fee Schedule 2014-2023
Treating California’s injured workers is much, much more costly in terms of time and administrative resources than treating Medicare patients. And, most California providers ...
Nov 15, 2023
Reader Response: CA Physician Fee Schedule vs Medicare Rates
Make no mistake: 2024 cuts to Medicare reimbursement rates will affect reimbursement rates for treating injured workers — but only for providers under discount reimbursement ...
Nov 13, 2023
Prime Health PPO: 2024 Medicare Cuts May Decrease Workers' Comp Reimbursement
The Centers for Medicare and Medicaid Services (CMS) announced it will cut reimbursement rates for physician services in 2024 by 3.4%.This Medicare reimbursemen...
Jun 8, 2022
CA OMFS: E/M Reimbursement vs Medicare Reimbursement
California workers’ comp allows discount networks to bleed the doctors who treat injured workers. Unfortunately for these workers and their employers, many of these financial...
Oct 28, 2020
CPT 99072 for Extra Time and Supplies for COVID-19
Medical practices, including practices that treat injured or sick workers, have implemented numerous changes to safely treat patients in person during the COVID-19 pandemic. ...
May 18, 2020
Audio-Only Telehealth Now Permitted in CA - Part 3
This is the third of our series on retroactive telehealth rule changes announced by the California Department of Workers’ Compensation (DWC) on 5/12/2020. Today we focus on t...
May 6, 2020
Medicare Releases REVISED Telehealth Rules - Part 2
This is part two of our series analyzing telehealth reimbursement rule changes that were announced last week by the Centers for Medicare & Medicaid Services (aka “CMS'' or “M...
May 5, 2020
Medicare Releases REVISED Telehealth Rules - Part 1
Last week the Centers for Medicare & Medicaid Services (aka “CMS” or “Medicare”) significantly changed its telehealth reimbursement rules to adjust to the demands of the COVI...
Apr 20, 2020
Telehealth Cheat Sheet: California Providers' Guide
For providers, COVID-19 has necessitated rapid shifts in healthcare delivery. Suddenly, telehealth is critical to continuing treatment while maintaining social distance and h...